Organization
YELLOWSTONE CARE CENTER, INC.
Active
Other names
Res Hab Direct Care
Organization subpart
No
Provider details
NPI number
Authorized official
JASON MCARTHUR (CFO)
(503) 362-5235
Entity
Organization
Contact information
Practice address
540 W SUNNYSIDE, IDAHO FALLS, ID 83402
(208) 523-9839
(208) 522-0224
Mailing address
3155 RIVER RD S STE 100, SALEM, OR 97302-9819
(503) 362-5235
(503) 585-3267
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
000143822
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807006600
—
ID
05
—
M8070066
—
ID
Enumeration date
08/12/2010
Last updated
08/12/2010
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